A 40-year-old female patient with a history of anxiety, uveitis, HLA B-27 +, migraines, bruxism, gastritis, smoker of 10 cigarettes/day.
Treatment lormetazepam 1 c/24 h.
The patient was operated on for a left renal incidentaloma by means of a 11th rib lumbotomy and neuropatic pain following thoracotomy in the intercostal nerve territory T11, with poor analgesic control.
We decided to fix intercostal spaces T10-T11 and T11-T12 with 0.5% bupivacaine + 40 mg of Trigon®, 5 ml in each space, VAS 1/10.
We started treatment with Lyrica® 75 mg plus Rivotril® 0.5 mg/24 h and Versatis® 5 % patches.
If pain, tramadol 10-15 drops every 8 h.
In the following review at 10 days, VAS 5/10.
We repeated instillation and maintenance of Lyrica® in ascending line, with EVA post instillation/10.
Let's remove 5 % Versati patches due to lack of effect.
Pulsed radiofrequency (RFP) was programmed in intercostal spaces T10-T11 and T11-T12, after obtaining local anesthetic, 0.5% bupivacaine plus dexamethasone 4 mg, 5 ml in each space.
Stimulation parameters are 45 Hz and 120 seconds.
We repeated the procedure a month later.
1.
Ten months later, the patient is asymptomatic (VAS0/10).
